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General NPI Number Information
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NPI Number | 1073516340
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Entity Type | Individual
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Provider Name | MARK TEDDER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 4230 HARDING PIKE SUITE 430
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City | NASHVILLE
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State | TN
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Zip | 37205-2013
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Country | US
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Telephone | 615-385-4781
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Fax | 615-385-9265
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Provider Business Mailing Address
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Address Line | 501 GREAT CIRCLE RD SUITE 200
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City | NASHVILLE
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State | TN
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Zip | 37228-1317
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Country | US
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Telephone | 615-222-7685
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Fax | 615-222-7237
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | MD029206
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License Number State | TN
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